Survey

Birthday
Name a kind of mental illness.
What is the first thought that comes to mind when you think of mental illness?
Name a movie or television show that deals with mental illness.
Do you know someone who currently suffers from a mental illness?	Yes No
Did you know someone who has suffered from a mental illness in the past?	Yes No
Mental illness is frightening to me.	Yes No
People with mental illness often get upset for no reason.	Yes No
I would be afraid to talk to someone who has a mental illness.	Yes No
I would be willing to be friends with someone who is mentally ill.	Yes No
I would feel embarrassed or ashamed if someone in my family had a mental illness.	Yes No
If you thought one of your friends had a mental illness, what would you do?
If you thought a member of your family had a mental illness, what would you do?
Have you heard of LifeWays?	Yes No
If so…Do you know what LifeWays does?	Yes No
Do you know how to get mental health services set-up for yourself?	Yes No
Do you know how to get a mental health evaluation done for your friend or family member?	Yes No
Do you have any other comments, suggestions, or concerns? If so...Share them here!